Organization
SOUTHWEST MICHIGAN RHUEMATOLOGY CENTER,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY M CASAS (MANAGER)
(269) 684-0259
Entity
Organization
Contact information
Practice address
3950 HOLLYWOOD RD, SUITE 280, SAINT JOSEPH, MI 49085-9151
(269) 408-0990
(269) 408-0993
Mailing address
3950 HOLLYWOOD RD, SUITE 280, SAINT JOSEPH, MI 49085-9151
(269) 408-0990
(269) 408-0993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301084645
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC9447
MEDICARE - RR
—
Enumeration date
02/06/2006
Last updated
11/08/2007
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